This suppression of free speech mirrors the administration's policies on abstinence-only education and outreach to sex workers. Participants at the UN meetings overwhelmingly suggest these policies through PEPFAR are interfering with efforts to have consistent messaging on HIV prevention through proven comprehensive sexuality education efforts, and on policies limiting how organizaitons receiving federal dollars can do outreach to sex workers.

Gabon, the current chair of the African Group is chairing a bloc of nations, but apparently in name only. In fact, there is an official African Union position that supports more aggressive positions that Gabon is ignoring. Nigeria deserves creidt for breaking from the pack and asserting that this is the moment the global community must hold one another accountable. The real pressure on the African Group is coming from Egypt, Yemen and Syria, none of whom are members of the African Group.

Why do these internal politics matter? At the UN, its all internal politics and diplomacy, to start with, but far more importantly is that, as a continent, Africa has clearly been hardest hit by AIDS and the issues of poverty that exacerbate the pandemic there. As a result, if any part of the world should be interested in making sure that the entire world is held accountable with global targets, measurable outcomes, financial commitments and human rights language that protects women and girls - it should be Africa. No, the US alone is not responsible for the current stalemate in the negotiations, but US leadership could break the logjam, if only certain ideological forces within the delegation would stop using Syria and the Organization of Islamic Countries as its front men.

Some nations are rumored to be secretly hoping the process stalls so they can avoid accountability. The US and South Africa are among a small group actively working to eliminate global targets for prevention and treatment, and most fundamentalist Islamic countries continue to campaign against any language to empower women and girls in any way or other basic human rights language. Some still resist the inclusion of strenthening sexual and reproductive health services as a way to help prevent the spread of this sexually transmitted disease. The US and Islamic countries are also teamed up in opposition to specific mention of vulnerable communities, those most affected by AIDS. Leaders seem to be ignoring the best advice and experience available to them.

The Rumor Mill has heard that the process has featured bilateral negotiations over specific sections of the declaration such that all the governments have not yet sat down together at once to negotiate. The latest draft from the co-chairs will be distributed Thursday morning -- and then governments will be given until 1:00 pm to contact their capitals and respond, apparently lacking consideration for nations on the other side of the planet.

Typical events like this feature negotiations over declarations in which all nations participate and are involved in the process throughout. Obviously, with an issue as serious as needing to get control over the 25-year-old AIDS pandemic, one would assume that nations of the world would be eager for an inclusive process in which all their voices are heard and their participation in the negotiations active and unquestioned by the citizens and governments they represent at home.

The story of this negotiation, while not yet finished, seems like it will be far from inclusive and participatory regardless of the outcome. Our sources have said that if a declaration is adopted that takes into account the very real changes in the pandemic, and the lessons learned by Civil Society, NGOs, medical, scientific and public health professionals, it will be a result of the governments of the world being goaded (perhaps shamed) into accepting accountability of global targets for measurable outcomes and financing for the global fight against AIDS. Supposedly, a press conference tomorrow morning with NGOs will bring light to some of these points.

Ironic, isn't it? The governments of the world who hold power are having to be pushed to exercise their voices at the United Nations by the NGOs and Civil Society representatives who often feel unheard in these high level diplomatic negotations, many of them HIV positive people who have dedicated their lives to ending the pandemic.

The world is waiting and public opinion is clearly demanding more be done, and that leaders be held accountable. The Rumor Mill will keep you posted as anything else arises.

Perhaps adding to the tension is one bit of language that the US delegation is suggesting: they want to change "evidence-based" (as in "evidence-based sexuality education," "evidence-based prevention efforts," etc.) to "evidence-informed."

Evidence-informed?!  Imagine the ramifications of such a document -- one that is supposed to be providing guidance for international response to HIV/AIDS...  "Yes, we're aware of the evidence.  We have been informed.  But we'd rather not do it that way."

As the public health community continues to voice its concern about the triumph of ideology over science (perhaps now over reason as well?), this news suggests that the US delegation is not listening. 

Rumor Mill hears that the emerging “Axis of Ideology” includes other fundamentalist representatives, all of which want to ignore the evidence as it relates to the importance of human rights, gender equality, comprehensive sexuality education, and sexual and reproductive health services in the fight to stem HIV/AIDS. Apparently, where science is concerned, the axis adheres to a strict, abstinence-only posture.